Avil22.7 mg

Avil is a first-generation (sedating) antihistamine used for the symptomatic relief of a variety of allergic conditions. Established/labeled uses include:

• Allergic rhinitis (seasonal and perennial) - relief of sneezing, rhinorrhea, and nasal/eye itching
• Urticaria (hives) and pruritus (itching) of allergic origin, including insect bite reactions
• Allergic conjunctivitis - relief of itching and redness of the eyes due to allergy (commonly used topically in combination with a decongestant such as naphazoline in eye drops)

Avil is also used as an adjunct/symptomatic component in various multi-ingredient cold, flu, and allergy combination products (together with decongestants, analgesics, or antitussives) to relieve associated sneezing, runny nose, and watery eyes.

Adjunctive use

Injectable Avil is sometimes used, under medical supervision, as an adjunct in the management of acute allergic reactions, in addition to first-line treatments such as epinephrine; it is not a substitute for epinephrine in anaphylaxis.

Each formulation of Pheniramine Maleate contains pheniramine maleate as the active ingredient. Commonly available strengths/forms include:

• Tablet: 25 mg Pheniramine Maleate
• Oral liquid/syrup: strengths vary by manufacturer
• Injection: 22.75 mg/mL (as Pheniramine Maleate) for intramuscular or slow intravenous use
• Ophthalmic combination drops containing Pheniramine Maleate together with a decongestant (e.g., naphazoline)

Exact strengths and dosage forms vary by manufacturer and market; consult the product package insert for the specific formulation dispensed.

Avil is a first-generation alkylamine-class antihistamine (H1-receptor antagonist) with additional anticholinergic and central nervous system depressant (sedative) properties. It is chemically related to other alkylamine antihistamines such as chlorpheniramine and brompheniramine.

Avil is available as oral tablets, oral liquid/syrup, injectable solution, and as an ingredient in combination ophthalmic and oral cold/allergy products, and is used to relieve symptoms caused by histamine release during allergic reactions.

Avil belongs to the class of first-generation (sedating) antihistamines, specifically the alkylamine derivative subgroup of H1-receptor antagonists.

Pheniramine Maleate acts as a competitive, reversible antagonist at histamine H1 receptors, blocking the actions of endogenously released histamine on smooth muscle, capillaries, and other tissues. This reduces symptoms such as itching, sneezing, rhinorrhea, and the vascular permeability changes seen in allergic reactions.

Because it crosses the blood-brain barrier, Pheniramine Maleate produces central nervous system depression (sedation, drowsiness), typical of first-generation antihistamines. It also has clinically significant anticholinergic (antimuscarinic) activity, accounting for effects such as dry mouth, blurred vision, urinary retention, and constipation, along with mild local anesthetic and antiserotonergic activity at higher concentrations.

Onset of action of oral Pheniramine Maleate is typically within 15-60 minutes, with a duration of action of approximately 4-6 hours.

Avil tablets and syrup may be taken with or without food; taking with food may reduce stomach upset. Swallow tablets whole with water and measure liquid/syrup doses with a proper measuring device.

The injectable form of Avil should be administered only by a trained healthcare professional, via intramuscular injection or slow intravenous injection.

Ophthalmic combination drops containing Avil should be instilled into the conjunctival sac; avoid touching the dropper tip to the eye or any surface. Contact lenses should generally be removed before instillation.

Because Avil causes drowsiness, avoid driving or operating machinery until you know how it affects you.

Avil has the following clinically significant drug interactions:

• Monoamine oxidase inhibitors (MAOIs): Concurrent use is contraindicated; MAOIs prolong and intensify the anticholinergic effects of Avil (see Contraindications).
• CNS depressants (alcohol, sedatives, hypnotics, opioids, benzodiazepines): Additive sedation and CNS depression can occur when taken with Avil; avoid or use with caution.
• Other anticholinergic drugs (e.g., tricyclic antidepressants, certain antipsychotics): Additive anticholinergic effects (confusion, urinary retention, constipation, blurred vision) may occur, particularly in elderly patients, when combined with Avil.

The most common side effect of Avil is sedation/drowsiness, which is prominent with this first-generation antihistamine. Other side effects may include:

• Dry mouth, dry nose and throat
• Blurred vision
• Urinary retention/hesitancy
• Constipation
• Dizziness, headache, mild hypotension
• Thickened bronchial secretions

In children, Avil may occasionally cause paradoxical excitation (restlessness, irritability, insomnia) rather than sedation.

Seek prompt medical attention for signs of a serious allergic reaction (rash, swelling of the face/lips/tongue, difficulty breathing) after taking Avil.

Pregnancy: There are limited well-controlled human studies of Avil use in pregnancy. It should be used during pregnancy only if clearly needed, and only if the potential benefit justifies the potential risk to the fetus. Consult a physician before using Avil during pregnancy.

Lactation: It is not well established whether Avil passes into breast milk. Because first-generation antihistamines may cause sedation or irritability in breastfed infants and may suppress lactation, Avil should be used during breastfeeding only under medical advice, weighing benefit against risk.

Because Avil commonly causes sedation, patients should exercise caution while driving, operating machinery, or performing other activities requiring mental alertness until they know how it affects them. Avoid concurrent alcohol or other CNS depressants (see Interactions).

Use with caution in elderly patients, who are more sensitive to the anticholinergic and sedative effects of Avil and are at increased risk of confusion, dizziness, and falls.

Use Avil with caution in patients with asthma or other chronic respiratory conditions (anticholinergic effects may thicken secretions), cardiovascular disease, hypertension, hyperthyroidism, and in those with a history of seizures, since first-generation antihistamines may lower seizure threshold.

Patients with narrow-angle glaucoma or symptomatic prostatic hypertrophy should not use Avil (see Contraindications).

Overdose of Avil may cause marked drowsiness or, particularly in children, paradoxical CNS stimulation (excitement, tremor, hallucinations, seizures), along with anticholinergic effects such as dry mouth, fixed/dilated pupils, flushing, and urinary retention. Severe overdose can progress to cardiovascular collapse, arrhythmias, or coma.

If overdose of Avil is suspected, seek immediate medical attention or contact a poison control center/emergency services right away. Do not attempt home treatment; management is supportive and should be provided in a medical facility.

Store Avil at room temperature (below 30°C), away from light and moisture. Keep out of reach of children.

Pediatric Use

Avil is contraindicated in newborns and premature infants. In older children, use only under medical supervision with age/weight-appropriate dosing; safety and efficacy of some formulations of Avil have not been formally established in all pediatric age groups. Watch for paradoxical excitation.

Geriatric Use

Elderly patients are more susceptible to the sedative and anticholinergic effects of Avil (confusion, dizziness, urinary retention, constipation, fall risk); use the lowest effective dose with caution.

Renal/Hepatic Impairment

No formal dose-adjustment guidelines are established; use Avil cautiously in patients with significant renal or hepatic impairment due to potential for reduced clearance.

Avil is generally used for short-term, symptomatic relief of allergic symptoms. Duration of use should follow product labeling or a physician's advice; if symptoms persist beyond 7 days, worsen, or are accompanied by fever, a physician should be consulted rather than continuing self-treatment with Avil.

Pheniramine Maleate is classified as an Antihistamine (H1-receptor antagonist), first-generation, alkylamine derivative.

Pheniramine Maleate works by competitively and reversibly blocking histamine at H1 receptors, preventing histamine-mediated effects such as increased capillary permeability, smooth muscle contraction, and stimulation of sensory nerve endings that produce itching and sneezing. Its central H1-blocking and anticholinergic activity also accounts for the sedative and drying effects of Pheniramine Maleate.

Avil is contraindicated in newborn and premature infants due to increased risk of severe adverse anticholinergic and CNS effects in this age group. In older infants and children, Avil should be used only under medical supervision, with dosing individualized by age and weight; safety and efficacy for certain indications and formulations have not been formally established in all pediatric age groups. Children may experience paradoxical excitation (irritability, insomnia, nervousness) instead of sedation.